Press release

Wed, Mar 13th 2013 08:05 am

Study
results indicate fundamental skills of robotic surgery appears to be
effective way to train surgeons

Researchers
from Roswell Park Cancer Institute and four collaborating
institutions have evaluated the effectiveness of a novel curriculum
to safely train surgeons on the da Vinci Surgical System, which is
used to perform robot-assisted surgeries. Results, published in
Urology,
showed that participants trained in the curriculum executed key
skills with greater precision than those who did not receive
training.

The
fundamental skills of robotic surgery training curriculum, jointly
developed by the study authors, uses the robotic surgical simulator,
or RoSS, to train surgeons in four basic areas required in
robot-assisted surgeries: orientation, motor skills, basic surgical
skills and intermediate surgical skills. Launched in 2010, RoSS, one
of the first robotic surgical simulators to accurately simulate the
da Vinci system, was developed by Dr. Khurshid A. Guru, director of
robotic surgery at RPCI, and Dr. Thenkurussi Kesavadas, director of
the virtual reality lab and a professor of mechanical and aerospace
engineering at the University at Buffalo.

In
this study, the researchers recruited 53 surgeons, fellows, residents
and medical students from four institutions: RPCI, UB, the Henry Ford
Health System in Detroit, and the Cleveland Clinic in Cleveland. Most
of the participants had no prior robotic or laparoscopic surgical
experience. The researchers randomly divided them into control and
experimental groups. Participants in the experimental group completed
the four-hour FSRS course; those in the control group did not.

On
a series of three tests, participants in the experimental group
executed a series of three tasks with more precision than their
counterparts who did not complete the FSRS curriculum, and completed
the tasks more quickly overall. Moreover, average performance
improved considerably for 23 "crossover" participants who did not
receive the initial training, but were allowed to repeat the three
tests following FSRS instruction.

It's
critically important that institutions that offer robot-assisted
surgeries develop training programs for their surgeons that
realistically simulate the surgical environment and build user
proficiency in core skills, said Guru, senior study author.

"A
situation where surgeons train only in the O.R., on live patients, is
far from ideal," he said. "The importance of this study is that
it gives us the first evidence we have that a carefully designed,
structured training curriculum, carried out in a risk-free, simulated
environment, is an effective way to translate the basic skills
required in robot-assisted surgery. The implications for improvements
in patient safety and long-term outcomes are tremendously
encouraging."

"The
idea of a simulation-based curriculum is gaining widespread
acceptance, and FSRS is now being used in many leading
robotic-surgery training programs nationally and internationally,"
said Kesavadas, a co-author on the study and co-developer of the RoSS
simulator.

"This
study shows the value of a structured curriculum while exposing a
laparoscopically naive surgeon to the robotic platform," said Dr.
Mani Menon, the Raj and Padma Vattikuti Distinguished Chair and
director of the Vattikuti Urology Institute at HFHS. "Given the
enormous cost of health care, any effort at off-line training is of
tremendous value."

The
researchers plan to do further research to establish the extent to
which completion of the FSRS curriculum may impact long-term surgical
proficiency. The development, testing and validation of RoSS and the
FSRS curriculum were facilitated by donations to the Roswell Park
Alliance Foundation and support from the John R. Oishei Foundation.

"The
John R. Oishei Foundation is committed to supporting projects that
will enhance patient safety and quality of care in Western New York
and beyond," said Robert D. Gioia, Oishei Foundation president.
"We're pleased to support the research around the FSRS
curriculum, which has been shown to enhance the training of robotic
surgeons in a structured and safe environment."

The
study, "Fundamental Skills of Robotic Surgery (FSRS): A
multi-institutional randomized controlled trial for validation of a
simulation-based curriculum," can be accessed at http://goo.gl/hqck8.